Individual
DR. CECIL MACK AYCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM. D.
Contact information
Practice address
516 NIZHONI BLVD, GALLUP INDIAN MEDICAL CENTER - PHARMACY, GALLUP, NM 87301-5748
(505) 722-1211
(505) 726-8621
Mailing address
516 NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1211
(505) 726-8621
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9502
TN
Other
Enumeration date
08/19/2006
Last updated
07/08/2008
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